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Prior Hormone-Replacement Therapy Linked to Reduced Risk of Metastasis to Bone, Lung, Liver

Prior Hormone-Replacement Therapy Linked to Reduced Risk of Metastasis to Bone, Lung, Liver

HEIDELBERG, Germany—Breast cancer patients who have received prior
hormone-replacement therapy (HRT) have a significantly reduced risk of
metastasis to bone, lung, and liver, according to a study reported by Ingo J.
Diel, MD, of the Institute for Gynecological Oncology in Mannheim Germany. Dr.
Diel was previously affiliated with the Department of Obstetrics and Gynecology
at University Hospital in Heidelberg, Germany. The German study supports
previous reports of improved outcome for breast cancer patients who have used
HRT.

"We know very well that we have a moderate but significant increased risk
for breast cancer in HRT users," Dr. Diel said. "But we know that for HRT and
breast cancer mortality it is a different story. Several, but not all, studies
on this topic show an improvement in overall survival in breast cancer patients
with a history of preoperative HRT use. They conclude that there is reduced
aggressiveness—by better grading of the tumor—slow-growing tumors, and smaller
tumor size."

Most Were Postmenopausal

The Heidelberg group performed a retrospective study involving 1,160
patients who underwent breast cancer surgery at University Hospital between
1990 and 2000. The age range was 45 to 70. Most of the women were
postmenopausal—847 compared to 313 women who were premenopausal.

Patients designated as HRT users had taken hormones for at least 1 year
prior to diagnosis (mean, 60 months). In the study population, 343 patients
were considered to be HRT users, and 504 patients were designated as nonusers.
Among the HRT users, 63.8% had used cyclic estrogen and progesterone.

The investigators’ analyses confirmed previous findings that HRT users have
an advantage in terms of tumor size and tumor grade. Moreover, the group of
patients who had not taken HRT had the highest death rates, and mortality was
greatly reduced in the postmenopausal HRT users. No significant differences
were found between HRT users and nonusers in terms of nodal status, hormone
receptor status, and S-phase fraction.

Completely New Finding

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